Friday, October 29, 2010
My first clinic visit at Operation Safe Drinking Water (I told you someone was going to get hurt on that dangerous, submerged dock in Bahia Grande!)
by Kelly N Patterson
Don’t worry-- I am not going to post every clinic visit here at the Operation Safe Drinking Water Base Camp (only the interesting ones!) However, because this was my first clinic visit since I arrived; and an excellent example of the unique challenges of health care out here; and recently, I predicted an ER visit from the exact location of today’s injury (remember the slimy submerged dock photo at Bahia Grande primary school?), I am posting about it. I am also hoping you get a better idea as to what challenges we face out here, as healthcare workers, in the remote islands off the coast of east Panama.
Ermelinda happens to be the wife of one of our local MacGyver’s around here named Benerito; he has been working with Operation Safe Drinking Water for over 2 years now as a general handyman/laborer. Benerito and Ermelinda have 3 kids and go to an evangelical Christian church EVERY night. Their children attend the very same primary school in Bahia Grande that I visited a few days ago with Maribel (Operation Safe Drinking Water has installed 2 rain catchment water tanks at this school—I have a whole photo album up on Face Book) as part of evaluating and monitoring the water tanks, and as part of my local community needs assessment.
Anyway, Little Benerito, aged 4, apparently slipped on that filthy, submerged (and no doubt germ/scum infested) dock (which is full of trash) and cut the very bottom of his heel-- and of course, it is infected; and of course, he has no shoes. Shoes are a luxury here (that is why Centro Infantil Cristiano was delivering shoes to children in villages outside of Changuinola; visit http://operationsafedrinkingwater.org/blog/volunteering-in-bocas-del-toro for the blog about this trip!) And of course, both he and his mother WALKED to my house.
And of course, the parents could not tell me when this happened exactly, nor if it involved metal, glass, wood, or what exactly cut him (if it was a rusty metal, we will know very soon and there will be a trip to the hospital for a tetanus shot and then some!)
So how do you clean and dress a deep, infected heel cut (a) for an active 4 year old; (b) a kid with no shoes, who basically lives on a swampy island; (c) people with no medicines at the house; (d) people you know are not using clean water to clean their bodies or home—people who use a river or the ocean to bathe; (e) people with no bathroom, so they go out in the bushes (stepping in other people’s poo); (f) people who do not know “Wash your hands” is the universal law of health—you see where this is going right?
It is not as simple as clean, dry, antibiotic cream, and bandage—how do you keep the bandage dry in these conditions? Even if they wanted to BUY shoes, there is not a shoe store on this island! How do you prevent the further spread of this infection to the boy and his family?!!!
Well, while Little Benerito was bravely soaking his heel in warm soapy water (the only time he shyly teared was when I applied a liquid antiseptic to the wound area—I knew it must be burning), I went through the treatment with both parents several times, which included—“before you clean his wound, wash your hands; after you clean his wound, wash your hands.”
Stressing that they had to soak his foot; clean it (I showed them how); dry it; apply antibiotic cream; and bandage it twice a day—an elaborate ritual that I sincerely hope they will follow. I tried to explain staph infection to them, showing them it would move up his leg to his heart (I think they got it.) I am pretty sure it is not staph infection, but I wanted the parents to know that I was serious about the treatment ritual—if they do not use clean hands and clean cloths, etc. then there really will be staph infection among them all.
“Make sure the cloth you use to clean his wound is CLEAN, with boiling hot water, and then clean the cloth again when you are done. “
I ended up giving Little Benerito one of my rainbow socks as a cover to the bandage (he loved it!) I told the parents to make him wear the sock over his bandage, take it off every night and clean it in boiling water, and let it dry while he sleeps—he will have to wear the same sock the next day.
And since my first clinic patient happened to be related to Benerito-- who is truly a hard-worker, always helpful and patiently teaching me Spanish daily (murcielago= bat), I ended up making my fave African dish (my curry tuna, spinach pasta dish) for Ermelinda and Little Benerito because they spent their lunch hour at the clinic.
During lunch, when not asking a million questions about Guaymi/Guomi customs and rituals, I amused them with photos of Africa. Benerito loved the photos of the animals (some animals he could not identify—they had never seen a gazelles, baboons, or ostriches); and Ermelinda was very interested in the local women’s market (something I have not yet seen here.)
I have chalk, so I let Little Benerito draw on my porch while I continued to learn about the local culture, or lack there of—according to Ermelinda, there is no traditional Guaymi/Guomi clothes or costume; and no traditional wedding ceremony (I showed her photos of a Zulu wedding to illustrate this); and there is no traditional “dance” (like the Honduran Garifuna “Punta”); etc. Interesting.
Every day I learn about 40 new things—from Spanish words to how to outsmart the bats to how to plant cilantro without the crabs eating it all.
Operation Safe Drinking Water partners with local community-based organization, Centro Infantil Cristiano
Outskirts of Changuinola, October 21, 2010—
In order to most effectively address and sustain the basic needs and primary health care of the local Guomi, or Guaymi, (indigenous) people of the Bocas del Toro region, it is critical that all sectors work together to meet community needs. Therefore, the Operation Safe Drinking Water (OSDW) team met up with a multi-purpose, Changuinola-based community organization named Centro Infantil Cristiano, last Thursday in Almirante.
Local Panamanian community organizer, Melva Marriot de Brid, is the ambitious and charismatic founder and president of two different community-based organizations: Centro Infantil Cristiano, which seeks to address mother and children’s health and welfare, and Centro de Ayuda y Rehabilitacion de Viviendas, which seeks to address drug and alcohol addiction throughout the Almirante region. Melva met the OSDW team in downtown Almirante, along with her two colleagues: former local preacher, Edgardo, and Rupert Harris, who is trying to set up youth sports development programs, in his spare time, throughout the area—mainly football, volleyball, and baseball.
Melva and her enthusiastic team (all wearing red shirts in the photos) took OSDW to three different Guomi (or Guyami) communities just outside of downtown Changuinola: San San Puente, Puente Negro, and Tibiti. She took OSDW to these communities to demonstrate the need for community rain-water catchment systems and basic primary health care education, as well as to deliver donated shoes to school children, some clothes, and snacks. NOTE: Even though public schools are free in Panama, families are still responsible for purchasing a school uniform, shoes, books, school supplies, and provide their own transportation to school—which is mainly walking through grassy (snake-filled) fields, across swamps and sometimes, crossing an un-bridged river.
Melva explained to OSDW that aside from distributing donated items to these communities-- which have an 80% unemployment rate; lack of public infrastructure (such as sidewalks, sanitation systems, electricity, poor public services, etc. ); low levels of education; poor housing conditions; and an average family size of 6 children-- Centro Infantil Cristiano has successfully launched several sewing income generation projects with local women’s groups; built 3 community “comedors” (or kitchens) where she has taught mothers how to prepare and cook nutritious foods for their families; and through Centro de Ayuda y Rehabilitacion de Viviendas, they have personally escorted extreme drug addicts, a 9-hour bus ride, to professional drug rehabilitation facilities in Panama City (Melva’s dream is to create a drug and alcohol rehab community home in Almirante.) In addition, Melva has authored a cook book, featuring typical Bocas region cuisine, entitled “Cocina Tipica de Bocas del Toro” (published in Spanish only, 2008), with all proceeds going to support her organizations.
Basically, Centro Infantil Cristiano has asked OSDW to partner in the creation of 6 new community comedors (kitchens) in the Changuinola outskirts--complete with nutritional education, cooking lessons and basic water/sanitation prevention and education— by installing 6 new community rain catchment water systems. Therefore, OSDW and Centro Infantil Cristiano will be working together to create 6 new community comedors throughout the region, complete with nutrition and sanitation awareness and education, as well as 6 community water tanks to provide clean, safe drinking, cooking and cleaning water.
To learn more about this joint community project, to donate, or participate, please contact OSDW at firstname.lastname@example.org or visit http://operationsafedrinkingwater.org.
Photo 1: Maribel Bass of OSDW handing out shoes to children in Puente Negro.
Photo 2: Joe Bass (OSDW) discussing partnering with Centro Infantil Cristiano in creating 6 community “comedors” (kitchens.)
Photo 3: (from left to right) Melva Marriot de Brid (CIC), Joe Bass (OSDW), Rupert Harris (CIC), Edgardo (CIC), and Maribel Bass (OSDW) holding boxes of donated school shoes.
Photo 4: An example of the current community water well at San San Puente—notice the rust and there is no cover—which means animals, debris, dirt, rubbish, and even small children can fall into the well. An open well can also serve as a breeding ground for mosquitoes and all kinds of amoebas—which lead to diarrhea, worms, and other water-born diseases.
Photo 5: Here is a photo of the local women and children gathering in San San Puente to pick up donations.
Photo 6: A typical house in all three communities—note: this house is home to a single mother with 10 kids.
Monday, October 11, 2010
Kelly N Patterson is moving to the island of San Crisotbal, part of the Bocas del Toro region of Panama in mid-October, 2010. Kelly will be working as Development and Communications Director for Operation Safe Drinking Water (http://operationsafedrinkingwater.org/blog/) which is a small, nonprofit community-based primary health care and rural development organization which serves indigenous Panamanian communities on over 30 islands.
More details to follow shortly!
More details to follow shortly!